The Clinic Study Of OSAS On Left Ventricular Configuration And Function By Doppler Tissue Imaging

Objective: To investigate the effect of OSAS on left ventricular configuration and function , provide the early sign for the clinic so as to valuate OSAS sufferer' s condition rightly and guide to make a diagnosis and give treatment correctly.Methods: Sixty-eight OSAS patients and thirty normal volunteers were evaluated by polysomnography (PSG) during sleep . Using pulse wave Dopper tissue imaging (PW-DTI) (the speed mode) , 2-dimensional echocardiogram (2-DE) and M-echocardiogram to measure the left ventricular structure and function , especially the change of diastolic function .At the same time , We measure the OSAS patients' index and compare it to the normal subjects .Results: 1) LVPW,IVS, LVMI and LVDd augment gradually with the deepening of the digree , the difference between OSAS group and that of the control were significant except LVDd . but was not significant among three unit of OSAS . OSAS with hypertension (HTN) have larger of AHI, BMI, LVPW, IVS and LVMI than that of controls ' . By regression analysis , AHI (β =0.360, P=0. 000) , LVPW (0=0.208, P=0. 018) ,LVDd ( β =0.201, P=0. 010)and SBPn( β=0.221, P=0. 017)were important factors that LVMI was increased by those . 2) The systolic function in OSAS patients trend to decrease with the disease aggravating , but the value of EF and FS still keep normal . however , The trend of lower in its systolic mitral annulus velocity wave (Sm) is very obvious. Especially in the severe group compared with normal subjects. In early days the OSAS mainly affected diastolic function, the systolic function was subjected to theinfluence smaller. By regression analysis , AHK β =-0.370, P=0. 000)FBG(β =-3. 141, P=0. 002) LVDd ( P =-3. 400, P=0. 001) is important factors that affect the diastolic function of left ventricular .3) Adopt the Em/ Am2 , the ratio was 60.29 % (41/68) . In the pseudonormal pattern , the value of Em/Am still continuously decrease, Em , Am were significantly lower than that of normal subjects . 4= 24h ambulatory blood pressure reveal that SBPd, DBPd, SBPn, DBPn, SBPm and DBPm pyramid with the aggravation of the disesase, the difference were significant , the day-and-night rhythm was fade away .By correlation analysis , SBPd DBPd SBPn DBPnand SBP were positive correlated to BMI and AHI . TC , TG , LDL and FBG were significantly higher in OSAS group than that of controls, but was not significant difference except TC and TG . HDL trend to descend with OSAS aggravateing, FBG were positive correlated to BMI and AHI , HDL was only negatively correlated to AHI .Conclusions: 1) AHI was the main and dangerous factor that made LVMI increment, caused the change of left ventricular structure . 2) The OSAS will damage the systolic and diastolic function, particularly to the change of the diastolic function. 3) The values of Em, Am and Em/ Am are sensitive index that evaluates the diastolic function of left ventricular. E/ Em>10 is the performance of abnormal diastolic function . 4) Sm is the index sign that evaluate the systolic function fastly and correctly . 5) The OSAS is important influence factor of blood pressure, fast blood glucose(FBG) and lipid metabolism .